In an effort to increase the number of black nurses in training, Lady Gladstone, wife of the British Governor General, started the King Edward VII Memorial order of Nurses in 1911. Contributions received from black people were used to train African and coloured nurses. (As Afrikaner women had similar problems with the English system of nursing, the order was criticised by the Afrikaner press for not having a similar project to assist Afrikaner women.) Despite efforts to facilitate the entry of black women into nursing and the urgent need for more nurses, progress was slowed down by racialised political and economic issues (Marks 1994:67; Searle 1972:271–275).
In later years, the BTNA designed leaflets which were printed and distributed to inform “Bantu girls” about nursing. Along with the information leaflet, the girls were also provided with a list of hospitals that provided training to black women (University of Witwatersrand 1935:1).
3.4.5.1 The debate about the category ‘lesser-trained nurse’
A debate regarding the acknowledgement of a category ‘lesser-trained black nurse’ commenced in 1912. Advocates of the secondary (lower than professional) nurse category stated that, if recognised by the medical councils, the less educated black women, who received hospital certificates, could be given formal recognition of training received and their nursing practice could be regulated. Furthermore, the nursing numbers in the country could be increased and especially the black population would benefit from the availability of nursing care. Those opposing the establishment of a
secondary category of nurses feared that it would keep the black nurses in a “secondary” status instead of giving them an opportunity to become professional registered nurses. The author of an article in The Christian Express (The month … 1914:1), a missionary newspaper printed in Lovedale, stated: “… the ordinary nurse’s examination is open for any Native nurse who possesses sufficient ability and a good enough knowledge of English to go in for it”. Others feared the economic implications of establishing a secondary category of nurse: this new category of nurse would be able to work for a lower salary than the professional nurse, thereby threatening the job position of the latter. The issue was only resolved 40 years later with the introduction of the Nursing Act of 1957 and, until after the Second World War, greatly hampered the entry of black women into nursing (Marks 1994:67; Searle 1972:271–275).
3.4.5.2 Working conditions in hospitals
English nurses were in control of nursing in South Africa, setting the standards of nursing and nursing training. Until the 1920s, nursing was considered a disgrace for white Afrikaner women – especially after marriage. Also, the death of large numbers of women and children in the British concentration camps during the second Anglo-Boer War (1899–1902) had a negative influence on Afrikaner-English relationships. Thus, few Afrikaner women entered the profession because they did not want to be dominated by the English nurse supervisors. Of those who did enter the profession, many left when they became married women. The strict discipline and strenuous working conditions also forced many to leave. Nursing training was minimal and nursing students were regarded as cheap labour. Yet, owing to the limited number of jobs available to white women, there were sufficient applicants, but insufficient posts available in the hospitals (Marks 1994:68–72; Potgieter 1992:139; Searle 1972:256).
Like their white counterparts, black women faced similar challenges of harsh working conditions, long hours and poor pay. However, they also had to perform domestic labour tasks in the wards, such as scrubbing floors, which white nurses did not have to do. The problems related to training posts and candidates available were similar to those experienced by white women (Marks 1994:102).
3.4.5.3 Limited nursing student posts
When the McCord Hospital opened its training doors in Durban in 1909, there were more nursing candidates than posts available. The hospital management only allowed the number of trainees needed to perform the actual work in the hospital. Therefore the hospital’s unwillingness to accommodate student nurses in training greatly hampered the number of student nurses entering the profession. Horwitz (2007:132) states that the Baragwanath Nursing College, which opened its doors in 1948, commenced with approximately 300 nursing student posts. Yet, between 2 000 and 3 000 applications were received. This imbalance between the number of student posts available versus the number of applicants did not improve with time: the new Baragwanath College, which opened its doors in 1982, could accommodate a maximum of 1 500 students per year while 20 000–30 000 applications were received. Given that Baragwanath Hospital developed as the largest nursing training hospital for black women in South Africa, the numbers mentioned above highlight two issues. First, it confirms statements that there were few work opportunities available to black women. Secondly, it links with Mashaba’s (Mashaba 1995:13; Sweet & Digby 2005:110) and Searle’s (1991:98) statements that few black women had the educational background required to enter into nursing. The issue of education was discussed extensively earlier in this chapter. If this perceived lack of educational suitability was evident as recently as 1982, it is reasonable to deduce that it was also a major problem in preceding decades. Thus large numbers of “unsuitable” black nursing candidates were excluded from the profession during times when those most ill and in need of care belonged to the black population of South Africa (Horwitz 2007:131–132; Marks 1994:6; Mashaba 1995:18).
3.4.6 The second Anglo Boer War: the socio-economic impact on nursing after